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Getting the right balance: insole design alters the static balance of people with diabetes and neuropathy

Overview of attention for article published in Journal of Foot and Ankle Research, October 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (70th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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7 tweeters
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1 Facebook page

Citations

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8 Dimensions

Readers on

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109 Mendeley
Title
Getting the right balance: insole design alters the static balance of people with diabetes and neuropathy
Published in
Journal of Foot and Ankle Research, October 2016
DOI 10.1186/s13047-016-0172-3
Pubmed ID
Authors

Joanne Paton, Sam Glasser, Richard Collings, Jon Marsden

Abstract

Over 1 in 3 older people with diabetes sustain a fall each year. Postural instability has been identified as independent risk factor for falls within people with Diabetic Peripheral Neuropathy (DPN). People with DPN, at increased risk of falls, are routinely required to wear offloading insoles, yet the impact of these insoles on postural stability and postural control is unknown. The aim of this study was to evaluate the effect of a standard offloading insole and its constituent parts on the balance in people with DPN. A random sample of 50 patients with DPN were observed standing for 3 × 30 s, and stepping in response to a light, under five conditions presented in a random order; as defined by a computer program; 1) no insole, 2) standard diabetic: a standard offloading insole made from EVA/poron®, and three other insoles with one design component systematically altered 3) flat: diabetic offloading insole with arch fill removed, 4) low resilient memory: diabetic offloading insole with the cover substituted with low resilience memory V9, 5) textured: diabetic offloading insole with a textured PVC surface added (Algeos Ltd). After each condition participants self-rated perceived steadiness. Insole design effected static balance and balance perception, but not stepping reaction time in people with DPN. The diabetic and memory shaped insoles (with arch fill) significantly increased centre of pressure velocity (14 %, P = 0.006), (13 %, P = 0.001), and path length (14 %, P = 0.006), (13 %, P = 001), when compared to the no insole condition. The textured shaped and flat soft insole had no effect on static balance when compared to the no insole condition (P > 0.05). Insoles have an effect on static balance but not stepping reaction time. This effect is independent of neuropathy severity. The addition of a textured cover seems to counter the negative effect of an arch fill, even in participants with severe sensation loss. Static balance is unaffected by material softness or resilience. Current best practice of providing offloading insoles, with arch fill, to increase contact area and reduce peak pressure could be making people more unstable. Whilst flat, soft insoles maybe the preferable design option for those with poor balance. There is a need to develop an offloading insole that can reduce diabetic foot ulcer risk, without compromising balance.

Twitter Demographics

The data shown below were collected from the profiles of 7 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 109 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 <1%
United Kingdom 1 <1%
Japan 1 <1%
Unknown 106 97%

Demographic breakdown

Readers by professional status Count As %
Unspecified 23 21%
Student > Bachelor 23 21%
Student > Master 23 21%
Student > Doctoral Student 8 7%
Student > Ph. D. Student 7 6%
Other 25 23%
Readers by discipline Count As %
Medicine and Dentistry 27 25%
Nursing and Health Professions 26 24%
Unspecified 25 23%
Engineering 7 6%
Sports and Recreations 7 6%
Other 17 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 October 2016.
All research outputs
#1,847,600
of 8,577,291 outputs
Outputs from Journal of Foot and Ankle Research
#181
of 405 outputs
Outputs of similar age
#73,563
of 254,385 outputs
Outputs of similar age from Journal of Foot and Ankle Research
#7
of 12 outputs
Altmetric has tracked 8,577,291 research outputs across all sources so far. Compared to these this one has done well and is in the 78th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 405 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has gotten more attention than average, scoring higher than 55% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 254,385 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 12 others from the same source and published within six weeks on either side of this one. This one is in the 41st percentile – i.e., 41% of its contemporaries scored the same or lower than it.